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Anxiety symptoms and risk of cognitive decline in older community-dwelling men

Published online by Cambridge University Press:  10 April 2017

Ahmed M. Kassem ,
Mary Ganguli Open the ORCID record for Mary Ganguli [Opens in a new window] ,
Kristine Yaffe ,
Joseph T. Hanlon ,
Oscar L. Lopez ,
John W. Wilson ,
Jane A. Cauley  and
for the Osteoporotic Fractures in Men (MrOS) Study Research Group
Ahmed M. Kassem
Affiliation:
Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
Mary Ganguli
Affiliation:
Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA Departments of Psychiatry and Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
Kristine Yaffe
Affiliation:
Departments of Psychiatry, Neurology and Epidemiology, University of California, San Francisco, California, USA
Joseph T. Hanlon
Affiliation:
Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
Oscar L. Lopez
Affiliation:
Departments of Psychiatry and Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
John W. Wilson
Affiliation:
Department of Biostatistics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
Jane A. Cauley*
Affiliation:
Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
*
Correspondence should be addressed to: Jane A. Cauley, DrPH, Department of Epidemiology, University of Pittsburgh, 130 DeSoto Street, A510 Crabtree Hall, Pittsburgh, Pennsylvania, USA. Phone: 412-624-3057; Fax: 412-624-7397. Email: jcauley@edc.pitt.edu.
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Abstract

Background:

Previous research regarding anxiety as a predictor of future cognitive decline in older adults is limited and inconsistent. We examined the independent relationship between anxiety symptoms and subsequent cognitive decline.

Methods:

We included 2,818 community-dwelling older men (mean age = 76.1, SD ±5.3 years) who were followed on an average for 3.4 years. We assessed anxiety symptoms at baseline using the Goldberg Anxiety Scale (GAS; range = 0–9). We assessed cognitive function at baseline and at two subsequent visits using the Modified Mini-Mental State Examination (3MS; global cognition) and the Trails B test (executive function).

Results:

At baseline, there were 690 (24%) men with mild anxiety symptoms (GAS 1–4) and 226 (8%) men with moderate/severe symptoms (GAS 5–9). Men with anxiety symptoms were more likely to have depressed mood, poor sleep, more chronic medical conditions, and more impairment in activities of daily living compared to those with no anxiety symptoms. Compared to those with no anxiety symptoms at baseline, men with any anxiety symptoms were more likely to have substantial worsening in Trails B completion time (OR = 1.56, 95% CI 1.19, 2.05). The association was attenuated after adjusting for potential confounders, including depression and poor sleep, but remained significant (OR = 1.40, 95% CI 1.04, 1.88).

Conclusion:

In cognitively healthy older men, mild anxiety symptoms may potentially predict future decline in executive functioning. Anxiety is likely a manifestation of an underlying neurodegenerative process rather than a cause.

Keywords

agingcommunity sampleepidemiologyexecutive function
Type
Research Article
Information
International Psychogeriatrics , Volume 29 , Issue 7 , July 2017 , pp. 1137 - 1145
Copyright
Copyright © International Psychogeriatric Association 2017 

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References

Andreescu, C., Teverovsky, E., Fu, B., Hughes, T. F., Chang, C. C. and Ganguli, M. (2014). Old worries and new anxieties: behavioral symptoms and mild cognitive impairment in a population study. American Journal of Geriatric Psychiatry, 22, 274–284.Google Scholar
Andrew, M. K. and Rockwood, K. (2008). A five-point change in modified mini-mental state examination was clinically meaningful in community-dwelling elderly people. Journal of Clinical Epidemiology, 61, 827–831.Google Scholar
Baxter, A. J., Vos, T., Scott, K. M., Ferrari, A. J. and Whiteford, H. A. (2014). The global burden of anxiety disorders in 2010. Psychological Medicine, 44, 2363–2374.CrossRefGoogle ScholarPubMed
Beaudreau, S. A. and O'Hara, R. (2008). Late-life anxiety and cognitive impairment: a review. American Journal of Geriatric Psychiatry, 16, 790–803.Google Scholar
Bierman, E. J., Comijs, H. C., Rijmen, F., Jonker, C. and Beekman, A. T. (2008). Anxiety symptoms and cognitive performance in later life: results from the longitudinal aging study Amsterdam. Aging Ment Health, 12, 517–523.CrossRefGoogle ScholarPubMed
Billioti de Gage, S. et al. (2012). Benzodiazepine use and risk of dementia: prospective population based study. BMJ, 345, e6231.Google Scholar
Blackwell, T. et al. (2014). Associations of objectively and subjectively measured sleep quality with subsequent cognitive decline in older community-dwelling men: the MrOS sleep study. Sleep, 37, 655–663.Google ScholarPubMed
Blank, J. B. et al. (2005). Overview of recruitment for the osteoporotic fractures in men study (MrOS). Contemporary Clinical Trials, 26, 557–568.CrossRefGoogle ScholarPubMed
Burton, C., Campbell, P., Jordan, K., Strauss, V. and Mallen, C. (2013). The association of anxiety and depression with future dementia diagnosis: a case-control study in primary care. Family Practice, 30, 25–30.Google Scholar
Buysse, D. J., Reynolds, C. F. 3rd, Monk, T. H., Berman, S. R. and Kupfer, D. J. (1989). The Pittsburgh Sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Research, 28, 193–213.Google Scholar
Byers, A. L. and Yaffe, K. (2011). Depression and risk of developing dementia. Nature Reviews: Neurology, 7, 323–331.Google ScholarPubMed
Byers, A. L., Yaffe, K., Covinsky, K. E., Friedman, M. B. and Bruce, M. L. (2010). High occurrence of mood and anxiety disorders among older adults: the national comorbidity survey replication. Archives of General Psychiatry, 67, 489–496.Google Scholar
Cherbuin, N. et al. (2009). Risk factors of transition from normal cognition to mild cognitive disorder: the PATH through life study. Dementia and Geriatric Cognitive Disorders, 28, 47–55.Google Scholar
de Bruijn, R. F. et al. (2014). Anxiety is not associated with the risk of dementia or cognitive decline: the Rotterdam Study. American Journal of Geriatric Psychiatry, 22, 1382–1390.CrossRefGoogle ScholarPubMed
Gallacher, J. et al. (2009). Does anxiety affect risk of dementia? Findings from the caerphilly prospective study. Psychosomatic Medicine, 71, 659–666.Google Scholar
Gallagher, D. et al. (2011). Anxiety and behavioural disturbance as markers of prodromal Alzheimer's disease in patients with mild cognitive impairment. International Journal of Geriatric Psychiatry, 26, 166–172.Google Scholar
Ganguli, M. (2009). Depression, cognitive impairment and dementia: why should clinicians care about the web of causation? Indian Journal of Psychiatry, 51 (Suppl. 1), S29–S34.Google Scholar
Ganguli, M. et al. (1993). Sensitivity and specificity for dementia of population-based criteria for cognitive impairment: the MoVIES project. Journal of Gerontology, 48, M152–M161.Google Scholar
Goldberg, D., Bridges, K., Duncan-Jones, P. and Grayson, D. (1988). Detecting anxiety and depression in general medical settings. BMJ, 297, 897–899.Google Scholar
Gum, A. M., King-Kallimanis, B. and Kohn, R. (2009). Prevalence of mood, anxiety, and substance-abuse disorders for older Americans in the national comorbidity survey-replication. American Journal of Geriatric Psychiatry, 17, 769–781.CrossRefGoogle ScholarPubMed
Kuller, L. H. et al. (2003). Risk factors for dementia in the cardiovascular health cognition study. Neuroepidemiology, 22, 13–22.Google Scholar
Lopez, O. L. et al. (2003). Psychiatric symptoms vary with the severity of dementia in probable Alzheimer's disease. Journal of Neuropsychiatry and Clinical Neurosciences, 15, 346–353.CrossRefGoogle ScholarPubMed
Mantella, R. C. et al. (2007). Cognitive impairment in late-life generalized anxiety disorder. American Journal of Geriatric Psychiatry, 15, 673–679.Google Scholar
Orwoll, E. et al. (2005). Design and baseline characteristics of the osteoporotic fractures in men (MrOS) study – a large observational study of the determinants of fracture in older men. Contemporary Clinical Trials, 26, 569–585.Google Scholar
Pachana, N. A., Byrne, G. J., Siddle, H., Koloski, N., Harley, E. and Arnold, E. (2007). Development and validation of the geriatric anxiety inventory. International Psychogeriatrics, 19, 103–114.CrossRefGoogle ScholarPubMed
Pahor, M., Chrischilles, E. A., Guralnik, J. M., Brown, S. L., Wallace, R. B. and Carbonin, P. (1994). Drug data coding and analysis in epidemiologic studies. European Journal of Epidemiology, 10, 405–411.CrossRefGoogle ScholarPubMed
Paterniti, S., Dufouil, C. and Alperovitch, A. (2002). Long-term benzodiazepine use and cognitive decline in the elderly: the epidemiology of vascular aging study. Journal of Clinical Psychopharmacology, 22, 285–293.CrossRefGoogle ScholarPubMed
Pietrzak, R. H. et al. (2012). Mild worry symptoms predict decline in learning and memory in healthy older adults: a 2-year prospective cohort study. American Journal of Geriatric Psychiatry, 20, 266–275.CrossRefGoogle ScholarPubMed
Plassman, B. L. et al. (2007). Prevalence of dementia in the United States: the aging, demographics, and memory study. Neuroepidemiology, 29, 125–132.CrossRefGoogle ScholarPubMed
Potvin, O., Forget, H., Grenier, S., Preville, M. and Hudon, C. (2011). Anxiety, depression, and 1-year incident cognitive impairment in community-dwelling older adults. Journal of the American Geriatrics Society, 59, 1421–1428.Google Scholar
Reitan, R. and Wolfson, D. (1985). The Halstead-Reitan Neuropsychological Battery: Theory and Clinical Interpretation. Tuscon, AZ: Neuropsychology Press.Google Scholar
Sheikh, J. and Yesavage, J. (1986). Geriatric depression scale: recent evidence and development of a shorter version. Clinical Gerontologist, 5, 165–173.Google Scholar
Sinoff, G. and Werner, P. (2003). Anxiety disorder and accompanying subjective memory loss in the elderly as a predictor of future cognitive decline. International Journal of Geriatric Psychiatry, 18, 951–959.Google Scholar
Teng, E. L. and Chui, H. C. (1987). The modified mini-mental state (3MS) examination. Journal of Clinical Psychiatry, 48, 314–318.Google ScholarPubMed
van Hout, H. P. et al. (2004). Anxiety and the risk of death in older men and women. British Journal of Psychiatry, 185, 399–404.Google Scholar
Washburn, R. A., Smith, K. W., Jette, A. M. and Janney, C. A. (1993). The physical activity scale for the elderly (PASE): development and evaluation. Journal of Clinical Epidemiology, 46, 153–162.Google Scholar
Wolitzky-Taylor, K. B., Castriotta, N., Lenze, E. J., Stanley, M. A. and Craske, M. G. (2010). Anxiety disorders in older adults: a comprehensive review. Depression and Anxiety, 27, 190–211.Google Scholar
Yaffe, K. and Boustani, M. (2014). Benzodiazepines and risk of Alzheimer's disease. BMJ, 349, g5312.CrossRefGoogle ScholarPubMed
Yochim, B. P., Mueller, A. E. and Segal, D. L. (2013). Late life anxiety is associated with decreased memory and executive functioning in community dwelling older adults. Journal of Anxiety Disorders, 27, 567–575.Google Scholar